TRACnet system, which uses cellphones in the field to gather
data about AIDS patients and their drug treatments. Photo credit:
Jonathan Donner
In a country that made headlines for a brutal
genocide that left an estimated 800,000 dead, Rwanda now counts
itself among several African nations battling with another devastating
enemy: AIDS. According to government estimates, about 4 percent
of adults living in rural areas and as many as 13 percent in Kigali,
the country’s
capital, are living with HIV/AIDS. With approximately one doctor
per 60,000 people in Rwanda, the number of people waiting for antiretroviral
(ARV) treatment is expected to be high for some time.
A major challenge to scaling up AIDS treatment
programs has been communications systems that rely on cumbersome
data-sharing processes. Hindrances in communication can delay responses
to drug shortages, causing disruptions in patient treatment and
increasing the probability of drug resistance.
But the government of Rwanda is taking an unusual and very effective
step in their plans to scale-up treatment. They are using cellphone
technology to streamline and expedite data sharing among health
workers using mobile or fixed telephone lines and the Internet,
in a project called “TRACnet.”
Today 67 clinics and 150 health workers around Rwanda use TRACnet
to follow patients’ progress, monitor drug supplies, and
share data affecting national policies — all within a matter
of seconds as opposed to days or weeks.
With this system, health workers can dial ‘3456’ or
log onto a bilingual (French and English) Web site and receive
patients’ test results as soon as they are processed. Prior
to TRACnet, patients waited up to a month for test results.
Having drug information available within seconds
also gives officials — such as ones at the Ministry of
Health, Rwanda’s Treatment and Research AIDS Center (TRAC), the
National Reference Laboratory, and CAMERWA, a pharmaceutical agency
coordinating drug supply for HIV/AIDS patients — the tools
they need to enhance patient services and reach their treatment
coverage goals, helping to avoid life-threatening interruptions
in the delivery of drugs.
Rwanda’s antiretroviral (ARV) program currently covers the
treatment needs of more than 13,000 HIV-positive citizens, with
a target of 101,000 patients by 2007.
According to Josh Ruxin, director of projects at the Center for
Global Health and Economic Development (CGHED), and principal investigator
on the TRACnet project, building human capacity is the “single
greatest factor” to ensuring people with HIV/AIDS have access
to the care they need.
“With TRACnet, we’re able to put
critical programmatic and patient-level information in the hands
of decision-makers and enable them to scale up services more rapidly,” says
Ruxin, whose Center is providing ongoing technical assistance to
the TRACnet project. “In the history of the AIDS epidemic
so far, the disease has far outpaced our systems and capacities
to respond; TRACnet is proving to be a critical new tool to react
and strategize in real time.”
TRACnet now serves as the national repository for sharing and
storing critical data affecting national programs on HIV/AIDS.
TRACnet is managed by a dedicated team of trainers and system administrators
at TRAC.
TRACnet was launched in January 2005 with funding from the U.S.
Centers for Disease Control and Prevention, CGHED (working closely
with Rwanda’s Treatment and Research AIDS Center (TRAC)), the Ministry
of Health, and Voxiva, a U.S.-based technology solutions provider.
The national phone company, RwandaTel, and the country’s cell
phone provider, MTN-Rwandacell, have set up toll-free numbers and
donated network time to support TRACnet.
Ongoing technical assistance is provided by CGHED’s Access
Project for the Global Fund, which is supported by a grant from
the Glaser Progress Foundation. Since 2002, the Access Project
team has been working closely with the Rwandan government in planning
and rolling out its HIV/AIDS strategy.
